目的观察急性胰腺炎(AP)患者血清IL-18水平的变化及其临床意义。方法选择AP患者58例,以正常健康人32例为正常对照组。所有AP患者均于起病后24h内入院,并根据Ransons’11项指标进行轻重分型,其中轻型(MAP)35例,重型(SAP)23例。所有入选者分别于入院后第1、3、7和14d检测血清IL-18水平。结果 AP患者入院后第1、3、7d,SAP和MAP患者的血清IL-18明显高于正常对照组(P<0.05),并且以第1d升高最为明显,第14d时则无明显差别;而SAP患者第1、3d的血清IL-18水平显著高于MAP患者(P<0.05),第7、14d时则无明显差别。入院后第1d SAP患者的Ransons’11评分为4.08±1.02,明显高于MAP患者的2.45±0.76(P<0.05)。所有AP患者入院后第1d的血清IL-18与Ransons’11评分有良好的正相关(r=0.289,P<0.05)。结论 IL-18参与了AP的发病,并与AP的严重程度相关,可以作为AP早期诊断和病情严重性评判的临床实验室指标。 Objective To observe the changes of serum IL-18 levels in patients with acute pancreatitis (AP) and its clinical significance. Methods Fifty-eight patients with AP were selected, and 32 healthy controls were selected as normal control group. All AP patients were admitted to the hospital within 24 hours after onset and were classified according to Ransons’11 criteria. Among them, 35 were light (MAP) and 23 were heavy (SAP). All participants were tested for serum IL-18 levels on days 1, 3, 7 and 14 after admission. Results The levels of IL-18 in SAP patients and SAP patients were significantly higher than those in normal controls on the 1st, 3rd and 7th day after admission (P <0.05), and the levels of IL-18 in SAP patients and MAP patients were the highest at the 1st day. There was no significant difference at the 14th day. Serum IL-18 levels in SAP patients at 1 and 3 days were significantly higher than those at MAP patients (P <0.05), but no significant difference at 7 and 14 days. On the first day after admission, the Ransons’11 score of SAP patients was 4.08 ± 1.02, significantly higher than that of MAP patients (2.45 ± 0.76, P <0.05). There was a positive correlation between serum IL-18 and Ransons’11 score on the 1st day after admission in all AP patients (r = 0.289, P <0.05). Conclusion IL-18 is involved in the pathogenesis of AP and is related to the severity of AP. It may serve as a clinical laboratory index for the early diagnosis and severity of AP.